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Home My WebLink AboutFIR2010-00038 Final Fireworks Stand - FIR Permit / Conditions - 12/29/2010 MASON COUNTY DEFT, OF COMMUNITY DEVELOPMEIYI ""r"-(380)- Phone: (360)427-9(i70,ext.352 Mason County Bldg. 3 426 W. Cedar R.O. Box 186 00 Shelton,WA 98584 w M I FIRE PROTECTION PERMIT FIR2010-00038 CM CD m a M APPLICANT: JOHN MILLER RECEiVED: 12/712010 � CONTRACTOR: LICENSE: EXP: ISSUED: 12121/2010 E-. SITE ADDRESS: 22950 NE STATE ROUTE 3 BELFAIR EXPIRES:6/21/2011 PARCEL NUMBER: 123326000044 LEGAL DESCRIPTION: SAM B. THELER'S HOME &GAR TRS TR 19-B PROJECT DESCRIPTION: FIREWORKS STAND GENERALINFUMMON System Information Type of Use: STND Audible Switches: PUII Station a: YP Heads:Sprinkler H Fire District: 2 Flow Svdtches: Visual Devices: Door Releases: Hood&Duct?: Pressure Switches:: Smoke Detector's: Duct Detectors: DryChemlcal?: Zones: Heat Detectors: Wet Chemical?: Sp�lrlkla�: Stand,pipeT SQUARE FOOTAGE FEES Moniloiing Company: oor; Type Amount Due Amount Pald Monitorlrg Phona No.:O- Second Floor: Fireworks Stand Permit 310100 $100.00 Auto F ire Alaim?: Wird Floor: Total: $100.00 $100.00 I _ III IC w 1✓� iLr) N 00 m �I N , N r-I _ples5a.mfer.tothe following pages for conditions of this.p I.Of 6 FIR201 0-00038 1,) uonsumer fire wuit s 111uy uc aviu "i11Y ., .......v ---,- — June 2alh from 12 noon to 11 PM June 29th to July 5th from 9 AM to 111 PM b6c- 21 r 3 t July 6th fom 9 AM to 112 noon 00 0o w M Only Washington State Fire Marshal approved class C common fire works may be sold. m m X CED ate. A lire works stand shall not be located more than 150 feetfrorn an approved access road. Shall be at least 100,feel from another fire works�stand Qoc nr separated by a road, street or highway at least 30 feet in width.Shall not be located any closer mail aii�wau by uho acW�i Feu Lo"— po erlhan 100 feet from any flammable fiquld or gas dispensing device, or 300 feet from anyilarnmable liquid or gas bulk �' exposures or be located clos Hstorage or dispensing facliily. X ''^ The minirriuln areas around a fire works stand, as specified in the attached table, shall be kept free from dry grass,brush,or combustible debris. This area shall a marked and fiadged. X Motor ve idles or trailers may not be parked within 20 feet of the lire works stand exceptwhen delivering, loading or unloading fireworks. Fireworks shall not be discharged within 300 featof any fireworks stand.A sign stating "No Fireworks discharge within 300 feet"in letters at least 2 inches high and in contrasting color shall be posted conspicuously on all sides of the structure. X � No smoking shall be allowed within the fireworks stand or flagged off area. Signs stating" No Smoking Witin 100 fear'to letters at least 2 inches high and in aontrasti g colors shall be posted conspicuosly on all sides of the structure. X All battery powered equipment, electrical equipement and cords shall be Ul.listed and used In accordance with that 1151itng. Extension cords shall be of an industrial qiiede type and shall be protected from physical damage. X All heating devices shall be UL listed.Only beating devices with sealed type elements shall be used, i.e. oil filled or water filled radiator type. Open Name or open elQment heating devices are prohibited. 0 w Generators shalt be located a minimum of 20 feet from any fire works stand. Fuel storage Is limited to 5 gallons. Ln X — 66 A minimum 24 inch wide isle shall be maintained inside the full length of the stand. T--1 Customers are not allowed inside the firevrorks stand.There shall be a minimum of 2 exits at least 28 inches in width located at oppsite ends of the stand. CD These exy s shall remain unlocked and unobstructed during hours of operation or when stand is occupied. N Sleeping inside a fireworks stand is prohibited. 1 f tat a fo1 towing pages for coed ivons of thl p$r�rt14t w 3.of 6 FIR2010-00038 1 is�.r� i1i"9j:l.tid a2:J 4 `• r IL A "• ___ t The location of the nearest phone shall be posted in the fireworks stand.All occupants of the stand shall be informed as to the location of rids phone. The N local emergency phone number, 9t f,and the address of the fireworks stand shall be conspicuously posted inside the stand. 00 0o X w m There shall b a minimum of 2 approved 2 112 gallon pressurized water fire extinguishers located adjacent to each exit door. X__ CD C`.ankin.open flame or any twee ofopen flanie equipment is prohibited in a fireworks stand. a X L Fireworks stands shall be locked when unoccupied and not open for business if fireworks are storged in the stand during these times. Fireworks stand E" shall not be locked when occupied. Fireworks maybe removed or transferrer)to a temporary storage structure or location approved as part of the license and permit. X. Fireworks may be stored in a locked and cured metal ortail frevvorks stand.truck,coniner or trailer that is at least 20 ieet wood n garage, shed,ban mother accessary building that is atleast 20 feet from the fireworks g om The fireworks snd durin business hours,or In a lacked and se stand._ X At least one person IS yrs of age or older shall ba on duty in the fireworks stand when fireworks are being sold to the public, Such person shall be responsible for the supervision of the fireworks stand and its operation. No person under tha age of 16 shall be allowed to occupy the fireworks stand when op to the public,It is illegal to knowingly sell fireworks to persons under the age of 16. A sign stating"No Sales of Fireworks to Persons Under the age of 16"in letters at least 2 inches high and in contrasting color shall be posted an the front of the stand. A photo 10 is required and it isresponslblityof the sellerto require proof of age. Driver's license or photo 10 showing date of birth issued by a public or private school, state, federal or-foreign govemment is acceptable. This permit becomes null and void if work orconstructlDn authorized is notcommnced whin i80 days,or if vonstnrction or work is suspended rare peiod of 18u lays at anytime ar�d� work is cornnrenoad. Evidence of continuation of work is progressinspeoWn within the t ao day period. Final inspection must be approved before building can beomupled.Proof of con raluation of work is by means of a progress inspe Ion.The owner orthe agent on the owners behalf,represents that the information provlded is accuralB and grantsernployees of Mason County access to the above desml*d property and struct a for reMewand inspecISon, i OL4NEK OR AGENT: DATE: o ' w Lr, N 00 ci B ci I c-1 N N c-1 Please refor t1kow following pages for conditlons of this permit.,, 4 of 6 FIR2010.00038 �y,�, -. m 'L ic CONCRETE MECHANICAL MANUFACTURED HOME F N Date By — - —• r Footings /Setbacks Ribbons m Gas Piping CInterior Date By interior-Date By Date By O Exterior Date By Exterior-Date By Set-up Q 2 000 Point Load I isolated Footings INSULATION Date BY z BG f SLAB INSULATION — -- Date By Data By FIRE DEPARTMENT Foundation Walls Floors Date By Date By Data By DECKS FRAMING Walls Date By Date By Data By PROPANE TANKS PLUMBING vault Date By Date By OTHER Groundwork Attic Type Data By Date By Date By D.w.v DRYWALL Type Int.Brace Wall Date By m Date 8y Date By _ �._ _ _...__._�_ N FINAL INSPECTION c Water Line Fire Separation Date By Dale By Date /Z-Lq v By c o Pass or Request Inspect. o Type of Insp. Fail Date Date Done By Comments 0 /�✓ C_ s7s 7- p /L-L to s 0 A O ri O 7 N O r. fA X O 0) Mason County z Fireworks Permit Application PO BOX 18i3 Permit#FIR _Z(�JT� �- ?�426 W Cedar St �... Shelton WA 98584 Receipt # D (360) 427�-9670 ext 273 RECEIVE CK # DEC 0-7 2010 Date Received - rJ- l0I0 AR ST. 426 W• -Permit for the Retail Sales or Public display of fireworks is required. A completed applicai:ion with required documentation and fees shall be submitted for Fire Marshal review. A hermit will be lissued upon satisfactory site inspection by the Fire Marshal. Applicant rnfoirmatio� Name: MalUng Address: W H ,Jtt 4c v City: S c 46eck- State: -W ZIP: 8 38 0 Contact Number 360 &ZO -t732 SP002:0r Inforumtiea Na me: _ k-e Mailing Address: i s' N w N R City: &a.l 8'tate: A- - Zfp: 9 b 4 Contact Number 36 0 6 Za - 3 Z Washington State.Fhiaaworks License-Information (Copy Required) License Igo.: G ( L( Z,` Date of c 4- 30 -Qo g • Issue: Q Pyrotechnic Operator license ( -Fireworks Stand License Bond or c:ertrficate ot,Insurance (COPY Of CCrtifieate/Bond Required) Provider: Fav Y,-u.r= (vtisi,ti4,V%4L ��wt Insured: SPH Pm c,- ve Certified F-Ivider. -) ,t Location cif stand/display Address.' ZZq 5D AJ E :54-uk XZ p 3 9t14,L� Directions to Site: rAA V o NF- 5-I&r ►UGC N E k Nex4-- f., Re►f�' 1<+.Sctt,,� Parcel Number.. 1 '7-3 3 �5- a000- y Legal Description: S,,� 13 - -rh e te#.5 a r TWS TQ 1�1- Legal ProPlrty Owner. F-FM * * Please see the reverse side to complete your application 20094244 15:29 360 427 7798 Paqe 2 3 3 Z sooa a y The:fogowing pertineat information MUST be erovided on the site diagram below Locations and Setback distances from the back,sides and front of retail sales stands or deli sated display areas,to: • Fu-e Hydrants O-jc • Property Lanes ,.yA,Lkk I" • Buildings N,a4r[n Padang Fj/3,rA'f,' • Combustibles uo4 Public Roads and Right of Ways' • Fue Lanes 'yA?Aao Private Roads and Right of Ways r 1 • Tmes/Brush I,I Aa14f/n Landmarks • Utk lities and Gas. UeK- Mortar separation distance N'Y am 1 ------------- 32, ST Pik Lt Applicants Affidavit I certily that the information provi h in is accurate and that compliance with all Coun ► F rat ining to the sales or discharge of fireworks shall t maintain s Sign Date FOR OFFICIAL USE ONLY BLLOW TMS LINE Accepted By. Date: 2009-12-14 15:30 360 427 7798 Paqe 3/7 The:foBqwmz pertiamt kdormsdob MUST be proyMed on the site diaw2p below Locations and Schack c5stanmes from tho beak,sides and front of retail sake stands or rated lay areas,to: it • Futi Hydrants OA • Properqr Lines • Bliikdings ✓ • Parking ✓ COPY 0 Combustibles "IA Public Roads and Right of Ways f • Fite Lanes '' • Private Roads and Right of Ways � wee 16 A • Tmes/BnLsh • Landmarks -" s�c�,caw cIS • Utilities and Gas Wh- • Mortar separation distance i -�S .t f4 {� • Dedguated landmg aria / 6^ �T i ! i3 h A v y y 'va P ,- apt•. ... _ ,` ' :�'�.�,m,E� �' �-.' , ""_.'".. ',.a ,',ti,. MASON COUNTY FIRE MARSHAL IIl ?B Mason County Bldg.III 426 W Cedar St PO BOX 186 Shelton,WA 98584 (360)427-9670 Ext.273 CODE ENFORCEMENT FIRE INSPECTIONS FIRE INVESTIGATION PUBLIC EDUCATION STANDARDS FOR THE OPERATION OF RETAIL FIREWORKS STANDS Sales Consumer fire works may be sold only on the following days and times. • June 28`h from 12 noon to 11 PM • June 29ih—July 5th from 9AM to 11 PM • July 61h from 9AM to 12 noon • December 271h— 31 S` from 12 noon to 11 PM Approved Fireworks Only Washington State Fire Marshal approved Class C common fireworks may be sold. Fireworks Stand Location • A fireworks stand shall not be located more than 150' from an approved access road, • Shall be at least 100' from another fireworks stand or separated by a road, street or highway at least 30' in width, • Shall not be located any closer than allowed by the table below to other structures or exposures, • Or be located closer than 100' from any flammable liquid or gas dispensing device, or 300' from any flammable liquid or gas bulk storage or dispensing facility. Retail Fireworks Stands—Minimum Clearances Buildings Combustibles Property Line Parking Motor Vehicle Motor Vehicle Traffic, Traffic, Public Road Private Way Back of Stand 20' 20' 5' 20' 20' 5' Side of Stand 20' 20' 5' 20' 20' 5' Front of Stand 20' 20' 20' 20' 20' 20' 1 r Surrounding Area around Fireworks Stands • The minimum areas around fireworks stands, as specified above, shall be kept free from dry grass, brush or combustible debris. This area shall be marked and flagged. • Motor vehicles or trailers may not be parked within 20' of the fireworks stand except when delivering, loading or unloading fireworks. • Fireworks shall not be discharged within 300' of any fireworks stand. A sign stating No Fireworks Discharge Within 300' in letters at least 2"high and in contrasting color shall be posted conspicuously on all sides of the structure. • No smoking shall be allowed within the fireworks stand or flagged off area. Signs stating No Smoking Within 100' in letters at least 2"high and in contrasting color shall be posted conspicuously on all sides of the structure. Electrical Supply & Usage • All battery powered equipment, electrical equipment and cords shall be UL listed and used in accordance with that listing. Extension cords shall be of an industrial grade type and shall be protected from physical damage. • All heating devices shall be UL listed. Only heating devices with sealed-type elements shall be used, i.e. oil filled or water-filled radiator type. Open flame or open element heating devices are prohibited. • Generators shall be located a minimum of 20' from any fireworks stand. Fuel storage is limited to 5 gallons. Fireworks Stand Operations • A minimum 24"wide isle shall be maintained inside the full length of the stand. • Customers are not allowed inside the fireworks stand. • There shall be a minimum of 2 exits at least 28"in width located at opposite ends of the stand. These exits shall remain unlocked and unobstructed during hours of operation or when stand is occupied. • Sleeping inside a fireworks stand is prohibited. • The location of the nearest phone shall be posted in the fireworks stand. All occupants of the stand shall be informed as to the location of this phone. • The local emergency phone number, 911,and the address of the fireworks stand shall be conspicuously posted inside the stand. • There shall be a minimum of 2 (two) approved 2 1/2 gallon pressurized water fire extinguishers located adjacent to each exit door. • Cooking, open flame or any type of open flame equipment is prohibited in a fireworks stand. • Fireworks stands shall be locked when unoccupied and not open for business if fireworks are stored in the stand during these times. Fireworks stands shall not be locked when occupied. Fireworks may be removed or transferred to a temporary storage structure or location approved as part of the license and permit. • Fireworks may be stored in a locked and secured retail fireworks stand,truck, container, or trailer that is at least 20' from the fireworks stand during business hours, or in a locked or secured metal or wooden garage, shed,barn or other accessory building that is a least 20' from the fireworks stand. • At least one person 18yrs of age or older shall be on duty in the fireworks stand when fireworks are being sold to the public. Such person shall be responsible for the supervision of the fireworks stand and its operation. No person under the age of 16 shall be allowed to occupy the fireworks stand when it is open to the public. • It is illegal to knowingly sell fireworks to persons under the age of 16. A sign stating"No Sale Of Fireworks to Persons Under the Age Of 16"in letters at least 2"high and in contrasting color shall be posted on the front of the stand. A photo ID is required and it is the responsibility of the seller to require proof of age. Driver's License or Photo ID showing a date of birth issued by a public or private school, state, federal or foreign government is acceptable. ACORD,. CERTIFICATE OF LIABILITY INSURANCE 517/20 o°"I/�`' PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION David Connolly Insurance A Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE y Agency HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 9393 Bayshore Dr ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Silverdale,WA 98383 INSURERS AFFORDING COVERAGE NAIC# INSURED INSURER A, National Fire 8n Marine Ins.Company Aurora Fireworks LLC INSURER B: 29399 Beach Dr NE INSURER C: POulsbo,WA 98370 INSURER 0: INSURER E COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR AWL POLICY NUMBER POLICY EFFECTIVE PgffiYM:KW LIMITS GENERALUAeaITY 72LPS-012423 5/1/2010 5/1/2011 EACH OCCURRENCE $ 1,000,000.00 X COMMERCIAL GENERAL LIABILITY REMISES EaEocNTEDaxenca $ 100,000.00 CLAIMS MADE �OCCUR MED EXP(Any one perom) $ 5,000.00 A PERSONAL 3 ADV INJURY $ 1,000,000.00 GENERALAGGREGATE S 2,000,000.00 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 1,000,000.00 X POLICY PIFFT F1 LOC AUTOMOBILE LIAWLITY COMBINED SINGLE LIMIT S ANY AUTO (Ea aaidm[) ALL OWNED AUTOS BODILY INJURY SCHEDULED AUTOS (Per Pew) HIRED AUTOS BODILY INJURY NON-OWNED AUTOS (Per ecdder1l) PROPERTY DAMAGE S (Per Bead") GARAGE UABILITY AUTO ONLY-EA ACCIDENT S ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: AGG $ EXCESSIUMBRELLALIABLLITY EACH OCCURRENCE $ OCCUR 71 CLAIMS MADE AGGREGATE S S DEDUCTIBLE $ RETENTION $ $ WORKERS COMPENUTM AND WC STATU OTH flBY l!! EMPLOYERS'IJABK.ITY E.L.EACH ACCIDENT ANY PROPRIETORIPARTNERIEXECUTIVE S OFFICER/MEMBER EXCLUDED? E.L.DISEASE-EA EMPLOYEd S M yea,describe under SPECIAL PROVISIONS belowE.L.DISEASE-POLICY LIMIT $ OTHER DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES!EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS Certificate holder& Mason County, Property Owner Joe Solif are listed as an additional insured for the fireworks stand at 22950 NE State Route 3 Belfair, WA 98528. CERTIFICATE HOLDER CANCELLATION Fireworks Supermarket SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION 15156 NW Hite Center Rd DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAUL 10 DAYS WRITTEN Seabeck, WA 98380 NOTICE TO THE CERTFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL IMPOSE NO OSUGATION OR UASIUTY OF ANY KIND UPON THE INSURER,ITS AGENTS OR RE?RESENTATNES. 4 THORIZE0 RE°RESENTA-,=_ '7 f��✓ ACORD 25(200 V081 ACORD CORPORATION 1988 Washington State Patrol 11414 Fire Protection Bureau Office Of The State Fire Marshal ANNUAL FIREWORK_ S STAND LICENSE Licensee: Fireworks Supermarket Contact Person: John Miller License Number: WSPFL-01428 Stand Number: SN•05108 [Vulid For One Stand] Date of Expiration: January 31,2011 Location: 2 2�S� N�S�c [Stand L cat n To$e Completed$y Licensee] State Fire Marshal Signature J� Licensee Signature